Tim Kaine isn’t focused on what the Senate isn’t doing on healthcare reform, but rather, on what needs to be done.

“My whole thing is, let’s not repeal the Affordable Care Act, let’s find things that are working, whether it’s in the Affordable Care Act or not, and let’s look at things that aren’t working, and find meaningful solutions to improve,” said Sen. Kaine, D-Va., in an interview with the Augusta Free Press on Capitol Hill on Thursday.

Senate Republicans have been crafting a healthcare reform package in response to the reform passed earlier this year by the House under a self-imposed early July deadline for action. Senate Minority Leader Chuck Schumer, D-N.Y., thinks it’s a 50-50 bet that GOP leaders will “do their own thing,” according to Kaine, who feels that one-party action on reform will be a disaster.

“My prediction is that if they do (that), we’re going to just be back talking about our healthcare system in crisis eight or ten months from now,” Kaine said.

Kaine’s Virginia colleague in the U.S. Senate, Mark Warner, feels the same way about the current Republican-only reform effort.

“If there was one thing we should have learned from 2009, doing big policy changes with only one party doesn’t end up with a product the American public is going to be happy with,” Warner said in a Wednesday Capitol Hill interview with AFP.

Fixing healthcare

Kaine is helping lead an effort to build momentum toward bipartisan reform. Kaine and Delaware Democrat Tom Carper have introduced the Health Insurance Marketplace Improvement Act, which would create a permanent reinsurance program similar to a program created under the Medicare Part D program.

“The individual marketplace has been pretty unstable,” Kaine said. “Premiums have been going up, and there are some parts of the country where insurers have been pulling out, leaving very little choice. The individual marketplace was tough before the Affordable Care Act passed. If you were trying to get health insurance not through an employer, it was not easy. But how do you stabilize it?”

The reinsurance program proposed in the Kaine-Carper bill would provide funding to offset larger than expected insurance claims for health insurance companies participating in the state and federal insurance marketplaces, encouraging them to offer more plans in a greater number of markets, improving competition and driving down costs for patients and families.

The bill would provide $500 million a year from 2018 to 2020 to help states improve outreach and enrollment for the health insurance marketplaces, drawing in new members and educating the public about the need to be insured. This outreach funding prioritizes counties where there are limited insurers left in the marketplace.

“The notion is, at some level, if a claim gets too high, there’s a backstop to cover it, so that insurers don’t have to price for the high claims,” Kaine said. “They can price for the average claims, and they know that there’s a federal backstop to take care of the high claims. That keeps everybody’s premiums down, and gives insurers more stability.

“Insurers now are dealing with so much uncertainty because the Trump administration is saying, We’re going to repeal ObamaCare, we’re not going to make the cost-sharing payments to insurance companies. They’ve refused to enforce certain aspects of it. So if you’re an insurance company, it’s very uncertain. That’s why so many are pulling out,” Kaine said.

Kaine and Carper filed the reinsurance bill to initiate dialogue with Senate Republican leaders, and Kaine said the effort has met with some positive response from the other side of the aisle.

“I was heartened yesterday as I was taking this bill around, I was hearing, I’m glad you’re doing that, I hope we get the chance to talk about this,” Kaine said.

No easy fix

The politics of healthcare reform are not easy. Both Kaine and Warner concede that.

“I don’t know what’s going to happen, but the American public is clearly against what came out of the House. And the idea that they’re going to try to jam this through in some covert way right before the Fourth of July recess would be bad policy and bad politics,” Warner said.

“There are some Republicans who don’t like the House bill because it’s not conservative enough, and a bigger group of Republicans that, in the words of President Trump, think the bill is too mean. So they’re having a hard time finding it. If they thought they could easily find a bill that they could do on their own, they’d probably do that,” Kaine said.

Republicans have backed themselves into a corner, though, in a manner of speaking, having campaigned for years on the promise that they’d repeal Obamacare given the first clear path to doing so.

Six months into controlling both houses of Congress and the White House, they’re really nowhere near repeal.

Kaine sees the reinsurance program bill that he and Carper are pushing as a step in the direction of bipartisan reform.

“I’ve really been encouraging the Republicans to drop the repeal effort, and let’s focus on the fix effort. And if they want to call that a replacement, I don’t care. Call it a replacement if you like. I’ll call it an improvement,” Kaine said.

Where things stand right now is not close to the territory of being considered improvement to Warner.

“The outrageousness of this, looking at the House plan, is 23.5 million people losing healthcare to give the richest Americans a tax break and to transfer $800 billion-plus of responsibility on Medicaid to the states,” Warner said.

“Virginia has to be the most harmed state of any by this transfer, because we didn’t do Medicaid expansion, and because we have a very frugal Medicaid program to start with. So that would mean if you try to block-grant it, where you start the Virginia block grant is so low that we get penalized for running an efficient program.”

The ball is in the GOP’s court, to Kaine.

“This is the moment between now and the end of June where the Republicans in the Senate have to decide, Are we really going to try to do this just on our own, no hearings from patients, providers, insurance companies, no public hearings, no opportunity for Democrats to propose amendments? Are we really going to do it all on our own? And what’s the chance if we do that we really fix anything? Or, are we going to open up the process and consider amendments?” Kaine said.

“The Senate might come up with a bill that’s better than the House bill, but the standard that we should be shooting for is President Trump’s promise. Nobody’s going to lose coverage, nobody’s going to pay more, nobody with a pre-existing condition is going to get kicked around,” Kaine said.

“I’ll vote for any bill that meets those three criteria, but the idea that a secretly drawn up Senate bill can meet these criteria with no hearings and no opportunity for Democratic amendments is virtually zero.”

Story by Chris Graham

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